Seeing their baby born through caesarean section and having a skin-to-skin cuddle with her soon after birth was more than Mark and Jeff Brown-Jones had expected.
It’s the norm for any other couple, but Mark and Jeff had rules and laws standing in the way of their relishing those intimate moments. Mark and Jeff are a same-sex couple who conceived a baby through a gestational carrier. They had to legally adopt their baby because both had provided sperm and they didn’t want to find out which of them is the real father.
Although the gestational carrier has no genetic ties with the baby, she became the legal mother on the baby’s birth certificate. The lack of legal status denied the couple the right to take the baby home right away or even watch her birth. But the couple was lucky that the hospital they worked with was flexible.
“Our OB-GYN had gone over to the hospital and briefed them all about the situation, so when we got there everybody kept saying ‘We are aware of your situation, we are going to work with you on things,’” Mark said. But the journey to reach this point hasn’t been easy for the couple.
Same-sex couples like Mark and Jeff who desire to have children have had to navigate through a confusing path in the past few years, as medical practitioners struggle to keep up both with the law and with the evolving composition of modern families.
Starting at Conception
The first hurdle for same-sex couples is finding a way to conceive a baby.
The process is more costly for same-sex male couples because they have the additional expense of finding a gestational carrier. It cost Mark and his spouse, Jeff Brown-Jones, nearly $100,000 to go through the process of getting donations from three different egg donors and two rounds of in-vitro fertilization.
The overwhelming price tag means fewer same-sex male couples seek to have children through surrogacy. Mark and Jeff were one of the first same-sex male couples to put in a request for consultation about surrogacy at Duke Fertility Center two years ago. The hospital wasn’t ready for them. “The Duke Fertility Center at this time is unable to help you with this type of treatment because of NC laws that only allow this for medically necessary patients and they don’t consider your situation to be medically necessary,” the hospital replied when Mark sent in the request.
“They kept saying they only do gestational surrogacy when it was medically necessary,” Mark said. “Well, explain to me medically how two guys can have a baby without gestational surrogacy?’ It seems like they were using that as an excuse.” According to Julia Woodward, fertility psychologist at Duke Fertility Center, the hospital had expanded its treatment to same-sex female couples, but for same-sex male couples, it was still a work-in-progress then.
“What I have seen in this field is there probably has been more comfort from the medical teams in the area treating two women than two men, related to an old bias that a child needs a mom.” Woodward said. “Our practice has changed in the past few years, but it took some time for all the protocols to be put in place.”
Duke Fertility Clinic wasn’t the only place that needed to review its policies regarding same-sex male couples. Mark and Jeff also consulted UNC Fertility, where their case would have to be scrutinized by an ethics committee because it involved a “known third party,” which was the gestational carrier.
Same-sex female couples also have to go through the ethics committee if the carrier uses the egg of her partner instead of her own. “They were very willing to work with us,” Mark said.
“But they have a little bit of a different situation where they actually have an ethics board to review any situation like ours.” Another factor that might influence a hospital or clinic’s decision to treat same-sex couples is religious beliefs. Kim Davis, the clerk in Kentucky who refused to issue marriage licenses to same-sex couples based on her religious beliefs, might not be an isolated case.
“I know some people in the south who until recently, still didn’t treat same-sex couples,” said John Park, doctor at Carolina Conceptions. “At least here at Carolina Conceptions we’ve always welcomed the LGBT community.”
Duke University, which Duke Fertility Clinic is connected to, has deep roots in the Methodist church. Woodward said she doesn’t think that plays a role in the decisions-making process. “That isn’t really a driving factor that has ever been raised when cases are reviewed,” she said. “I wasn’t even aware that Duke has a Methodist faith.”
Birth and beyond
The remaining challenges come after the child is born. Although UNC Rex Hospital was flexible in allowing Mark and Jeff time with the baby, some minor frustrations were still present because the adoption papers weren’t ready yet.
They had to hope for an empty hospital room to be available because the baby couldn’t be discharged to them before the gestational carrier was discharged.
There were only two baby identification bracelets and one went to the gestational carrier. The other went to Mark—Jeff was left out. “That meant if the baby wasn’t in the nursery, she could only be in my care,” Mark said.
“If I went down to the car to get something, she couldn’t be left in the room with Jeff because he doesn’t have the bracelet.”
Despite these hiccups, Mark said their experience was very positive and they know that some of their friends do not experience the same level of understanding. Fertility clinics and hospitals are slowly catching up, redefining terms, updating protocols and straightening out details to accommodate same-sex couples.
“None of this stuff at the hospital was “discriminatory,” Mark said. “The policies in place just didn’t account for our situation.”
